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Background and Objective: Cardiovascular disease (CVD) is a significant cause of morbidity and mortality worldwide, with high-risk patients requiring effective management to reduce their risk of cardiovascular events. Bempedoic acid is a novel therapeutic agent recently approved as an add-on therapy to statins in patients with uncontrolled LDL-c. Bempedoic acid inhibits cholesterol synthesis in the liver, which ultimately reduces the risk of cardiovascular events. Therefore, the present study aims to assess the efficacy and safety of bempedoic acid in patients with uncontrolled LDL-c (Previously on moderate or high-intensity statins) with a high risk of CVD in real-world settings. Methods: This is a multicenter, retrospective, observational study on the data of high-risk-CVD patients collected from Bempedoic Acid on Efficacy and Safety in patients (BEST) Registry. The clinical data of 140 patients who were already on statin therapy and were receiving Bempedoic acid at a dose of 180 mg, along with measurements of the level of LDL-c, HbA1c, HDL, TG, TC, PPPG, FPG, AST, ALT, serum creatinine was taken into consideration. The primary outcome includes a change in LDL-c level, and secondary outcomes involve a change in the level of HbA1c, HDL, TG, TC, PPPG, FPG, AST, ALT, and serum creatinine at week 12 and 24. Adverse events were reported at both time points. Results: A total of 140 patients were included in the present study with a mean age of 51.8 ± 9.2 years and had primary confirmed diagnosis of dyslipidemia with uncontrolled LDL-c. The mean levels of LDL-c decreased from the mean baseline value of 142.67 ± 46.49 mg/dL, to 106.78 ±33.92 mg/d; a statistically significant reduction by 23.23% (p < 0.01) at week 12. Similarly, at week 24, the mean LDL-c value reduced to 90.39 ± 38.89 mg/dL. A 33.38 % decrease was observed (p < 0.01). Other parameters such as non-HDL, FPG, PPPG, AST and serum creatinine also showed statistically significant reduction at week 12 and week 24. Conclusion: The present study demonstrates that bempedoic acid is an effective add-on medication in lowering LDL-c levels in high-risk CVD patients with uncontrolled LDL-c.
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@#Introduction: Dyslipidemia is a significant factor in cardiovascular and other diseases. Corn can be used to treat dyslipidemia. This study is to determine the effect of boiled corn water on levels of HDL-C, LDL-C, triglycerides (TG), and total cholesterol (TC) in people with dyslipidemia in certain areas in Indonesia. Methods: We used a quasi-experimental pretest-posttest control group design. A sample of 40 people for each group was taken using a purposive sampling technique. The group was given the intervention of corn-boiled water @ 200cc twice daily for seven days. Blood lipid profile using fasting and examined by Fluorometric-enzymatic assay method. All procedures are carried out based on operational standards. Within-group comparisons used the Wilcoxon test, while between-group comparisons used the Mann-Whitney U and Independent T-Test. Results: The LDL-C control group experienced an increase of 65.1 mg/dL, and the entire group’s lipid profile variation showed no difference between the pretest and posttest (p>.05). The intervention group showed an increase in HDL-C (0.1 mg/dL), a decrease in LDL-C (30.2 mg/ dL), TG (27.0 mg/dL), and TC (35.6 mg/dL). Within-group comparison of the intervention group showed HDL-C (p.153), LDL-C (p.001), TG (p.023), and TC (p<.001). A between-group comparison showed HDL-C (p.101), LDL-C (p.034), TG (p.003), and TC (p.006). Conclusion: Whole corn boiled water provides good evidence that it is effective in lowering LDL-C, TG, and TC, as well as improving dyslipidemia in HDL-C patients. This intervention can be used as an alternative treatment for dyslipidemia in terms of nutrition.
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【Objective】 To investigate the clinical characteristics, long-term follow-up rate, level and control rate of low-density lipoprotein cholesterol (LDL-C) in patients with atherosclerotic cardiovascular disease (ASCVD) aged ≥75 years who underwent percutaneous coronary intervention (PCI) during hospitalization. 【Methods】 We selected ASCVD patients aged ≥75 years with PCI from January 2016 to December 2020 in The First Affiliated Hospital of Xi’an Jiaotong University, collected the baseline data of the patients and the follow-up of 1 month, 3 months, 6 months and 12 months after discharge by HIS system, and analyzed their LDL-C and control rate at each follow-up. 【Results】 A total of 1 129 patients were enrolled in this study, aged 78 (ranging from 75 to 89) years. Among them 72.1% were male; myocardial infarction was the main type of ASCVD (71.5% ); hypertension was the most common risk factor, accounting for 85.2% (717/842), followed by diabetes, 58.6% (493/842); 74.6% met the ultra-high risk criteria of the 2020 Chinese Expert Consensus on Lipid Management in Ultra-High Risk ASCVD Patients, and the LDL-C control rate was only 8.1% . The four routine follow-up rates of 1 129 elderly ASCVD patients were 49.5%, 24.1%, 17.1%, and 24.6%, respectively. The detection rates of LDL-C during follow-up were 26.3%, 5.3%, 10.4%, and 13.8%, respectively. LDL-C control rates in ultra-high risk ASCVD were 59.4%, 45.1%, 37.1%, and 17.6%, respectively, while LDL-C control rates in non-ultra-high risk ASCVD patients were 67.3%, 55.6%, 47.4%, and 44.0%, respectively. 【Conclusion】 The elderly patients with ASCVD-PCI were mainly ultra-high risk patients. The routine follow-up rate and the LDL-C compliance rate during follow-up were low and showed a downward trend.
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Homozygous familial hypercholesterolemia (HoFH) is a rare and serious autosomal genetic metabolic disease. Patients without intervention often die younger than 30 years old from early atherosclerotic cardiovascular disease (ASCVD)incurred by extremely high levels of low-density lipoprotein cholesterol (LDL-C). We present a case of HoFH, a child with compound heterozygous mutation in this study. The effect of conventional lipid-lowering therapy through diet control and lipid-lowering drugs was unsatisfactory. The blood-lipid purification proves effective but has poor compliance and difficult to maintain for a longer time. The patient received orthotopic liver transplantation and had been followed for 2 years, with the patient shows normal LDL-C, well growth and development. We hope the case will provide the clinician with better understanding of the diagnosis and treatment of the rare disease of HoFH.
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Dyslipidemia is an important cause of atherosclerotic cardiovascular disease (ASCVD) worldwide that leads to increased risk of morbidity and mortality; treating dyslipidemia to goal reduces the risks. This article reviews the pharmacological therapy of dyslipidemiawhich is often required in addition to life style intervention to achieve target lipid levels.Currently, there are seven types of approvedlipid modifying drugs which are effective in treating dyslipidemiawhen used singly or in combination. Statins are considered as first line drug and havebeen used extensively in the primary and secondary prevention of ASCVD. Ezetimibe is used as a first line add-on drug for patients already on a statin who have not reached their low density lipoprotein (LDL-C) goals;however,ezetimibe can be used as initial drug in statin intolerant patients. Bile acid sequestrants are a useful alternative to statins or ezetimibe in pregnant women or patients with liver disease. They also lower blood glucose and are useful in diabetes mellitus (DM). The PCSK9 inhibitors are powerful lipid modifying drugs, are expensive, needinjection for delivery, and are used when statin in maximum doses with other drugs cannot lower the LDL-C level to targets in patients with very high CV risk. Fibrates have recently shown to slow the progression of microvascular diseases and are found beneficial for DM with hypertriglyceridemia and microvascular complications. Currently, niacin use is markedly decreased due to development of more effective alternative drugs for managing dyslipidemia andbecause of the adverse effects related to niacin use.Recent trials reveal that, ω-3 fatty acids, when added in pharmacological doses to statin therapy (after controlling LDL-C), are effective in reducing CV events in patientshaving moderate hypertriglyceridemia with high or very high CV risks
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Objective: To assess the expanding needs on lipid-lowering treatment in patients with acute coronary syndrome (ACS) by applying newly issued definition of extreme high-risk, which is proposed by Chinese expert consensus on lipid management of extreme high-risk atherosclerotic cardiovascular disease (ASCVD) patients of Chinese Society of Cardiology (CSC). Methods: Data of this study was derived from the Improving Care for Cardiovascular Disease in China (CCC) project, which was a case-based nationwide registry study and launched as a collaborative initiative by the American Heart Association and the CSC. The project consecutively recruited ACS patients from158 tertiary hospitals and 82 second hospitals across China, and detailed clinical information of patients was collected. This study enrolled ACS inpatients in CCC project from November 2014 to July 2019. The proportion of extreme high-risk patients, their characteristics, mean LDL-C levels at admission, the gap between measured LDL-C level and the new target, and lipid-lowering therapy at discharge were assessed. Results: Among 104 516 ACS inpatients enrolled in this study, 75.1% (78 527/104 516) met the criteria of extreme high-risk and were expected to achieve the new LDL-C goal. Among patients at extreme high-risk, 21.2% (16 651/78 527) had multiple severe ASCVD events and 78.8% (61 876/78 527) had 1 severe ASCVD event and at least two high-risk factors. For the extreme high-risk patients, the mean level of LDL-C at admission was (2.8±1.0) mmol/L, prevalence of LDL-C ≥1.4 mmol/L was 93.4% (73 307/78 527) and the median gap between LDL-C level at admission and the target of 1.4 mmol/L was 1.3 (0.8, 2.0) mmol/L. If LDL-C could be further reduced to 50% of the admission level, we estimated that 55.6% (43 632/78 527) of the extreme high-risk patients would achieve the new LDL-C goal. Among 40 875 patients with information about discharge statin dosage, 93.5% (28 004/29 947) of the extreme high-risk patients were prescribed with statins at discharge, and among them 95.1% (26 632/28 004) received statin monotherapy and 91.1% (25 501/28 004) were at moderate doses of statins. Conclusion: About three fourth of inpatients with ACS were categorized as extreme high-risk based on the new definition of CSC expert consensuses, nine out of ten patients at extreme high-risk didn't achieve the new LDL-C target at admission, and the intensity of lipid-lowering therapy was insufficient in clinical practice. There are substantially expanding needs for implementing more intensive and effective lipid-lowering strategies.
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Humans , Acute Coronary Syndrome/drug therapy , Asian People , Cardiology , China , Cholesterol, LDL , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Lipids , United StatesABSTRACT
Diabetes is a major global epidemic, currently affecting approximately 451 million adults worldwide. The present study was undertaken to establish the relation between lipid profile and the risk of cardiac diseases. Cardiac issues and stroke are said to be more prevalent and different from that of non-diabetic perspectives and heavy alcohol consumption affects all the metabolism. 400 subjects were included in the study of which 200 were healthy controls non-alcoholics and control alcoholics 100 in each respectively under the name - Group I and the remaining 200 were diabetic non-alcoholics and diabetic alcoholics 100 in each labeled under- Group II, both from the age group of 35-55 years. The result specified that there is a strong alliance between alcohol consumption in diabetes, lipid profile and its effect leading to cardiac diseases.
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Humans , Child , Adolescent , Dyslipidemias , Brazil , Prevalence , Risk Factors , Hospitals, UniversityABSTRACT
@#Background: Simvastatin is usually taken in the evening due to the circadian rhythm of hepatic cholesterol biosynthesis. The degree of reduction of low-density lipoprotein cholesterol (LDL-C) and the level of adherence to different administration time remained unknown in the Malaysian population. This study aims to investigate the effect of simvastatin on the percentage changes of lipid profile and the level of adherence to when simvastatin was instructed to be taken at different timing. Methods: Nine primary care health clinics across Malaysia participated in this study. 147 statin-naive subjects were selected through convenient sampling and randomised into one of the three arms (after breakfast, after dinner or before bedtime). Differences on percentage reduction of LDL-C from baseline and level of adherence among the three groups at week-16 were compared. The main outcomes measured in this study were the percentage change of lipid parameters and the percentage of high-adherence (MMAS=8) at week-16. Results: 59.2% of the patients were male. The mean age of the study population was 53.93± 10.85 years. Most of the patients were Malays (69.4%); followed by Indians (22.4%) and Chinese (8.2%). LDL-C decreased from 4.26 (Standard Deviation, SD1.01) to 2.36 (SD0.69)mmol/L at week-16 for patients taking simvastatin before bedtime; an absolute reduction of 44.95%.The differences of LDL-C percentage reduction between three arms were significantly different (p<0.001). The greatest LDL-C reduction was observed when simvastatin was taken before bedtime and revealed 56.2% patients with high-adherence at week-16. Conclusion: Simvastatin showed superior LDL-reduction and higher level of adherence when being instructed to be taken before bedtime
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@#【Objective】The aim of this study was to investigate the associations between serum complement C3，C4 and low density lipoprotein cholesterol（LDL- C）levels and early- onset coronary heart disease.【Methods】We enrolled 255 cases of coronary angiography confirmed coronary artery disease from January 2018 to September 2018. All the patients were divided into early- onset coronary heart disease group（108 cases）and late- onset coronary heart disease group（147 cases）. Besides ，100 healthy subjects were enrolled and used as controls. Serum levels of C3 ，C4 and LDL-C were analyzed by automatic biochemical analyzer.【Results】Levels of serum C3，C4 and LDL-C in early-onset coronary heart disease group，late-onset coronary heart disease group and healthy control group were significantly different（P < 0.05）. In early-onset coronary heart disease group，C3 and C4 were positively correlated with LDL-C（P < 0.05）. However ，there was no significant correlation （P > 0.05） between C3 ，C4 and LDL- C in late- onset coronary heart disease group and healthy control group.【Conclusions】The levels of C3 and C4 were positively correlated with LDL-C only in the early-onset coronary heart disease patients.
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OBJECTIVE@#To observe the effects of herbal-cake-separated moxibustion on the repair of damaged vascular endothelium structure and the content of stromal cells derived factor 1 (SDF-1) in rabbits with atherosclerosis.@*METHODS@#A total of 75 rabbits were randomly divided into a normal group, a model group, a direct moxibustion group, an atorvastatin calcium group and a herbal-cake-separated moxibustion group, 15 rabbits in each one. The rabbits in the normal group were fed with normal diet, and the remaining rabbits were fed with high-cholesterol diet for 12 weeks to prepare atherosclerotic model. Two groups of acupoints, one was "Juque" (CV 14), "Tianshu" (ST 25) and "Fenglong" (ST 40), the other one was "Xinshu" (BL 15), "Ganshu" (BL 18) and "Pishu" (BL 20), were applied in the direct moxibustion group and herbal-cake-separated moxibustion group; the two groups of acupoints were selected alternatively every other day. The moxibustion was given for 30 min per treatment, once a day for 4 weeks. The rabbits in the atorvastatin calcium group were treated with atorvastatin calcium tablets (1.96 mg•kg•d) which were crushed into powder and mixed into breakfast. After modeling, the rabbits in the normal group and model group received no treatment, and immobilized at the time when moxibustion was applied in other three groups. The levels of total cholesterol (TC) and triglyceride (TG) were measured by enzymic method; the low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured by colorimetric method; the morphological structure of aortic wall was observed under optical microscope; the serum level of SDF-1 was determined by enzyme-linked immunosorbent assay (ELISA).@*RESULTS@#After treatment, compared with the normal group, the levels of TC, TG and LDL-C were significantly increased in the model group (all <0.01), and the level of HDL-C was decreased (<0.01). Compared with the model group, the levels of TC, TG and LDL-C were significantly decreased (all <0.01), and the level of HDL-C was significantly increased in the direct moxibustion group, atorvastatin calcium group and herbal-cake-separated moxibustion group (<0.01, <0.05). Compared with the normal group, the morphological structure of aortic wall was significantly damaged in the model group. Compared with the model group, the vascular endothelial structure was improved in the atorvastatin calcium group and herbal-cake-separated moxibustion group, and the pathological change of aorta endothelial in the direct moxibustion group was relieved. After treatment, compared with the model group, the level of SDF-1 was increased in the direct moxibustion group, atorvastatin calcium group and herbal-cake-separated moxibustion group (<0.05, <0.01); the level of SDF-1 in the herbal-cake- separated moxibustion group was higher than that in the direct moxibustion group (<0.05).@*CONCLUSION@#The herbal- cake-separated moxibustion can promote the expression of SDF-1 in serum and repair the damaged aortic endothelial structure.
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Animals , Rabbits , Acupuncture Points , Atherosclerosis , Endothelium, Vascular , Hyperlipidemias , MoxibustionABSTRACT
Resumen Durante mucho tiempo, los esfuerzos para disminuir el riesgo cardiovascular en los adultos se centraron en el intento de reducir tanto como fuese posible las concentraciones plasmáticas de colesterol 6, LDL (c-LDL). Hasta muy recientemente se concluyó que en los estudios clínicos de medicamentos con acción en los lípidos circulantes no existía evidencia directa que permitiera determinar cuál es la mejor meta de c-LDL para la disminución del riesgo cardiovascular y tampoco se concedió importancia suficiente a los eventos adversos de las diferentes combinaciones farmacológicas recomendadas para el logro de las concentraciones de c-LDL más bajas posibles. El análisis exhaustivo realizado para la actualización del Programa para el Control del Colesterol en el Adulto de Estados Unidos (NCEP-ATP-III), que comprendió una gran cantidad de estudios controlados con distribución al azar, permitió en 2013 la postulación de un nuevo paradigma de tratamiento que abandona el concepto de metas determinadas de c-LDL y que insiste en la importancia de las modificaciones favorables en el estilo de vida, además de que recomienda la administración preferencial de estatinas, en tipos y dosis fijas, debido a que un importante volumen de evidencia ha demostrado que estos agentes atenúan la progresión de la aterosclerosis coronaria y promueven la regresión de ésta, con lo que disminuyen significativamente la morbilidad y mortalidad cardiovasculares en la prevención primaria y en la secundaria. En este nuevo paradigma terapéutico fue posible también la identificación de los grupos de pacientes que pueden beneficiarse con la administración de estatinas. En consensos y guías más recientes, algunas asociaciones sostienen la necesidad de lograr ciertas metas de cLDL de acuerdo con el riesgo, pero mantienen a las estatinas como el pilar del tratamiento, solas o en combinación con ezetimiba o con antagonistas de la convertasa de proproteínas subtilisina/kexina de tipo 9 (PCSK9: proprotein convertase subtilisin/kexin type 9). En este artículo se revisa la evidencia clínica relativa a la administración de atorvastatina, que en gran medida permitió el desarrollo del nuevo paradigma de manejo del riesgo cardiovascular.
Abstract For a long time, efforts to reduce cardiovascular risk in adults focused on the attempt to reduce plasmatic LDL cholesterol (LDLc) levels as much as possible. Until very recently, it was concluded that in clinical studies of drugs with action on circulating lipids, there was no direct evidence to determine the best LDLc target for cardiovascular risk reduction, and that adverse events, or the almost absent demonstration of impact on hard outcomes of the different pharmacological combinations recommended for the achievement of the lowest possible LDLc concentrations, were not considered. The comprehensive analysis for the update of NCEP-ATP-III (National Cholesterol Education Program, Adult Treatment Panel III), which included a large number of controlled and randomized trials, allowed in 2013 the postulation of a new treatment paradigm, which leaves the concept of specific goals of LDLc and postulates the importance of favorable lifestyle modifications and which commends the pre-ferential use of statins, fixed doses and type, because a large volume of evidence has shown that these agents attenuate the progression of coronary atherosclerosis and promote the regression of this, which significantly decrease cardiovascular morbidity and mortality in both primary and secondary prevention. In this new therapeutic paradigm, it was also possible to identify the groups of patients that can benefit from the use of statins. In more recent consensuses and guidelines, some associations support the need to achieve risk-adjusted LDLc, but keep statins as the mainstay of treatment, alone or in combination with ezetimibe or proprotein convertase subtilisin/kexin type 9 (PCKS-9) antagonists. This article reviews the clinical evidence regarding the use of atorvastatin, which allowed the development of the new cardiovascular risk management paradigm.
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Introduction: India leads the world with largest number of diabetic patients and is often referred to as the diabetes capital. Diabetic dyslipidemia in India is one of the main causes for Coronary Artery Disease (CAD) mortality of the world. Dyslipidemia are disorders of lipoprotein metabolism, including lipoprotein overproduction or deficiency. It is a preventable risk factor which is mostly observed in diabetes patients and that may precipitate the cardiovascular disorders. Our aim of the study is to determine the impact of type 2 diabetes mellitus (T2DM) on lipid profile of diabetic patients reporting at tertiary care hospital. Materials and methods: It was a cross sectional study conducted at Civil Hospital and Gujarat Medical Education Research Society, Medical College, Valsad, Gujarat, India. Total 140 diabetic patients were randomly selected form OPD and IPD of our hospital and they were examined for dyslipidemia. Fasting blood glucose concentration and Lipid Profile [Total Cholesterol (TC), High Density Lipoprotein (HDL), Very Low Density Lipoprotein (VLDL) and Triglycerides (TG)] were investigated by using commercially available reagent kits in Biochemistry analyzer. Collected data was analyzed by using appropriate software. Results: Out of total 140 diabetic patients examined, the mean age of patients was 48.93 ± 12.1 years. In present study we found the mean Fasting Blood Sugar (FBS) was 188.76 ± 54.63 mg/dl. The prevalence rates in our study for high Total Cholesterol (TC) and Triglycerides (TG) were 13.6% and 41.4% respectively. The prevalence rates for high LDL-C, very high LDL-C and low HDL-C in the diabetic subjects were 8.6%, 5.0% and 72.9% respectively. Conclusion: The diabetic patients had elevated serum total cholesterol, elevated triglyceride (triacylglycerol) and slightly elevated low density lipoprotein (LDL-C) and reduced levels of high Gamit DN, Mishra A. A lipid profile study amongst the patients of type 2 diabetes mellitus - A cross sectional study. IAIM, 2018; 5(2): 1-5. Page 2 density lipoprotein (HDL-C) indicating that diabetic patients were more prone to cardiovascular diseases.
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Coronary atherosclerotic heart disease (CHD) remains the leading cause of morbidity and mortality in the world, with elevated low density lipoprotein-cholesterol (LDL-C) levels as a major risk factor. Lower levels of LDL-C can effectively reduce the risk of CHD. To date, lipid-lowering medicines such as statins are effective in lowering LDL-C, but a proportion of patients do not achieve lipid reduction target with statins or are intolerant to statins. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a new class of agents reducing LDL-C which gain more and more concerns. Through inhibitory effect on PCSK9 and increasing low-density lipoprotein receptors recycling, they can significantly reduce serum LDL-C levels. PCSK9 inhibitors are currently in phase III of clinical trials, and the results showed that they had good lipid-lowering effects and tolerability. This review provided an overview of the latest advances and challenges about PCSK9 inhibitors.
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Coronary atherosclerotic heart disease (CHD) remains the leading cause of morbidity and mortality in the world, with elevated low density lipoprotein-cholesterol (LDL-C) levels as a major risk factor. Lower levels of LDL-C can effectively reduce the risk of CHD. To date, lipid-lowering medicines such as statins are effective in lowering LDL-C, but a proportion of patients do not achieve lipid reduction target with statins or are intolerant to statins. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a new class of agents reducing LDL-C which gain more and more concerns. Through inhibitory effect on PCSK9 and increasing low-density lipoprotein receptors recycling, they can significantly reduce serum LDL-C levels. PCSK9 inhibitors are currently in phase Ⅲ of clinical trials, and the results showed that they had good lipid-lowering effects and tolerability. This review provided an overview of the latest advances and challenges about PCSK9 inhibitors.
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<p><b>OBJECTIVE</b>Low-density lipoprotein cholesterol (LDL-C) has been well known as the risk factor of coronary artery disease (CAD). However, the role of lipoprotein (a) [Lp(a)] in the development of CAD is of great interest but still controversial. Thus, we aim to explore the effect of Lp(a) on predicting the presence and severity of CAD in Chinese untreated patients, especially in combination with LDL-C.</p><p><b>METHODS</b>We consecutively recruited 1,980 non-treated patients undergoing coronary angiography, among which 1,162 patients were diagnosed with CAD. Gensini score (GS) was used to assess the severity of CAD. Lp(a) was measured by immunoturbidimetric method.</p><p><b>RESULTS</b>Patients with CAD had higher level of LDL-C and Lp(a) compared with non-CAD (P < 0.05). Multivariable logistic regression revealed that Lp(a) > 205 mg/L (highest tertile) predicted 1.437-fold risk for CAD (95% CI: 1.108-1.865, P = 0.006) and 1.480-fold risk for high GS (95% CI: 1.090-2.009, P = 0.012) respectively. Interestingly, concomitant elevated level of Lp(a) and LDL-C conferred the highest risk for both presence [OR = 1.845, 95% CI: 1.339-2.541, P < 0.001] and severity [OR = 1.736, 95% CI: 1.188-2.538, P = 0.004] of CAD.</p><p><b>CONCLUSION</b>Lipoprotein (a) is a useful marker for predicting the presence and severity of CAD, especially combined with LDL-C.</p>
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Aged , Female , Humans , Male , Middle Aged , Asian People , Biomarkers , Coronary Angiography , Coronary Artery Disease , Diagnosis , Cross-Sectional Studies , Lipoprotein(a) , Blood , Risk FactorsABSTRACT
Resumen La enfermedad cardiovascular aterosclerosa ocupa el primer lugar mundial en morbilidad y mortalidad. El principal factor de riesgo de enfermedad es el colesterol unido a lipoproteínas de baja densidad (C-LDL). El tratamiento farmacológico de elección para reducir el C-LDL son las estatinas; sin embargo, han sido insuficientes para eliminar el riesgo cardiovascular, especialmente en pacientes con formas primarias de hipercolesterolemia relacionadas con mutaciones genéticas, o intolerantes a estatinas. Es de gran importancia el desarrollo de nuevos fármacos para abatir el riesgo que persiste a pesar de la administración de estatinas. La proconvertasa subtilisina-kexina 9 (PCSK9) es un regulador primordial de la cantidad de receptores de LDL, ya que su función es dirigir dichos receptores a su destrucción lisosomal. El advenimiento de anticuerpos monoclonales para bloquear la PCSK9 ha permitido mejorar la cantidad y eficiencia de los receptores de LDL, de esto resulta la disminución notable del colesterol circulante. Hasta el momento, la eficacia e inocuidad de estos anticuerpos resultan aceptables, y los datos preliminares en cuanto a su efecto en la reducción de la morbilidad y mortalidad cardiovasculares son alentadores.
Abstract Atherosclerotic cardiovascular disease represents the leading cause of morbidity and mortality in most countries. The main risk factor for developing this disease is low density lipoprotein cholesterol (LDL-C). The pharmacological treatment of choice for reducing LDL-C is statins; however, in spite of the widespread use of statins, these drugs have been insufficient to eliminate cardiovascular risk. This residual risk is most relevant in patients with primary forms of hypercholes-terolemia associated with genetic mutations, or in those who are intolerant to statins. The development of new drugs to reduce residual cardiovascular risk is of vital importance. Proprotein convertase subtilisin-kexin 9 (PCSK9) is an important regulator of the amount of LDL receptors since its function is to direct these receptors to their lysosomal destruction. The development of monoclonal antibodies to block extracellular PCSK9 has allowed us to improve the quantity and efficiency of LDL receptors, resulting in a significant decrease in plasma cholesterol. Efficacy and safety of these antibodies is currently considered acceptable and preliminary data are encouraging but still insufficient to assess the favorable impact of these antibodies in reducing cardiovascular morbidity and mortality.
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Objective To evaluate the value of low-density lipoprotein-cholesterol (LDL-C) and non-high-density lipoprotein-cholesterol (non-HDL-C) in differential diagnosis of familial hypertriglyceridemia (FHTG) and familial combined hyperlipidemia (FCHL).Methods We recruited 9 FHTG pedigrees (94 subjects) and 24 FCHL pedigrees (94 subjects) and then divided them into affected groups and non-affected groups according to lipid abnormality.Another 10 normal control pedigrees (57 subjects) served as controls.We compared the routine lipid levels such as triglyceride (TAG),total cholesterol (TC),HDL-C and LDL-C and non-HDL-C between the groups.After stratification based on TAG level,we observed the relationship between LDL-C and non-HDL-C.Last we confirmed and analyzed the cut-off value of differential diagnosis between FHTG and FCHL with receiver operating characteristic (ROC) curve.Results The levels of TAG,TC,and non-HDL-C were significantly higher in the affected group of FHTG than in the non-affected group of FHTG and the normal group (P＜0.01 or P＜0.05).The levels of TAG,TC,HDL-C,LDL-C and non-tHDL-C wcrc significantly higher in the affected group of FCHL than in the non-affected group of FCHL and the normal group (P＜0.01 or P＜0.05).The levels of TAG were significantly higher (P＜0.01) while TC,HDL-C,LDL-C and non-HDL-C levels were significantly lower (P＜ 0.01 or P＜0.05) in the affected group of FHTG than in the affected group of FCHL.The association between LDL-C and non-HDL-C was positive both in FHTG and FCHL,but the relationship became weaker as TAG level increased.The cut-off value of LDL-C and non-HDL-C was 3.575 mmol/L and 4.525 mmol/L,respectively.Conclusion In addition to the routinely used lipid indexes,non-HDL-C may be a new index for differential diagnosis of FHTG and FCHL,and may be superior to LDL-C in this regard.
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Chronic kidney disease (CKD), also known as chronic renal disease, is progressive loss in kidney function over a period of months or years. The symptoms of worsening kidney function are not specific, and might include feeling generally unwell and experiencing a reduced appetite. Chronic liver disease in the clinical context is a disease process of the liver that involves a process of progressive destruction and regeneration of the liver parenchyma leading to fibrosis and cirrhosis. "Chronic liver disease" refers to disease of the liver which lasts over a period of six months. It consists of a wide range of liver pathologies which include inflammation (chronic hepatitis), liver cirrhosis, and hepatocellular carcinoma. The entire spectrum need not be experienced. Lipid profile or lipid panel is a panel of blood tests that serves as an initial broad medical screening tool for abnormalities in lipids, such as cholesterol and triglycerides. The results of this test can identify certain genetic diseases and can determine approximate risks for cardiovascular disease, certain forms of pancreatitis, and other diseases. Aim of the present study To study the changes in Lipid Profile M. Madan Mohan Rao, Shivnath Nandan, G. Obulesu, Salma Mahaboob R. To study the changes in lipid profile induced after ingestion of single high-cholesterol test meal in subjects of chronic liver disease and chronic renal disease. IAIM, 2017; 4(1): 50-57. Page 51 Induced after Ingestion of Single High-Cholesterol Test Meal in Subjects of Chronic Liver Disease and Chronic Renal Disease. Materials and methods, present study was conducted in the department of General Medicine, RIMS, Kadapa, by taking 50 patients of both the sexes. Serum was separated within four hours by centrifugation and the tests are serum total cholesterol (STC), serum Triglycerides (STG), HDL-cholesterol, LDL-cholesterol and VLDL-Cholesterol. Statistical analysis of the data was done by using paired ‘t’ test and student ‘t’ test. As no such comparative prior studies have been done on COPD patients, it was strongly urged that further studies with larger sample groups be carried out to elucidate the quantitative and qualitative significance of these changes.
ABSTRACT
Diabetes mellitus is the most prevalent metabolic non communicable disorder in the world. Diabetes mellitus type 2 is a long term metabolic disorder that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Type 2 diabetes is typically a chronic disease associated with a ten-year-shorter life expectancy. This is partly due to a number of complications with which it is associated, including: two to four times the risk of cardiovascular disease, including ischemic heart disease and stroke. To study the prevalence of microvascular, macrovascular, nonvascular complications and associated risk facters such as dyslipidemia obesity and hypertention in newly diagnosrd type 2 diabetes patients.